Medicare Part A

What it helps cover:

• Hospital care

• Skilled nursing facility care

• Nursing home care (as long as that isn't the only care you need)

• Hospice care

• Home healthcare

What it costs:

Most people generally don't pay a monthly premium for Original Medicare Part A because they paid Medicare taxes while they were working. However, if you don't qualify for premium-free coverage (ususally by working 10+ years), your monthly premium would be $311.00 for 7.5 to 10 years worked and $565.00 for feweer than 7.5 years worked. 

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Other Part A costs for 2026:

• Hospital stays (per-benefit period*)

             Deductible: $1,736.00.

             Days 1-60: $0 coinsurance after the deductible.

             Days 61-90: $434.00 daily coinsurance.

             Lifetime Reserve Days (Days 91+): $868.00 daily coinsurance

             (up to 60 days total over your lifetime).

• Skilled Nursing Facility (SNF) stays (per benefit period*):

             Days 1-20: $0 coinsurance after deductible of $1736.00 is met.

             Days 21-100: $217.00 daily coinsurance.

             After Day 100: You pay all costs. 

• Mental Health Services while admitted as an inpatient (per benefit period*):

             Days 1–60: $0 coinsurance after the deductible of $1736.00 is met.

             Days 61–90: $434.00 daily coinsurance.

             Days 91 and beyond: $868.00 per "lifetime reserve day" (up to 60 days total over your lifetime).

             Professional Services: You generally pay 20% of the Medicare-approved amount for services from doctors and other providers received while hospitalized (typically covered under Part B). 

• Medicare Hospice Benefit:

             For eligible individuals, it provides comprehensive comfort care (palliative care) and support services like nursing, medical equipment, pain medication, aide services, and counseling, with patients usually only paying small copays for prescriptions and respite stays. Eligibility requires a doctor to certify a prognosis of 6 months or less to live and choosing comfort care over curative treatments for the terminal illness. 

• ​ 20% copay for Medicare-approved durable medical equipment (DME).

• *Benefit Period: It starts the day you're admitted to a hospital or SNF. It ends when you haven't received inpatient care for 60 consecutive days. You have a new deductible for each new benefit period

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Items and services Medicare A doesn't cover:

• Long-term care (also called custodial care)

• Most dental care

• Eye exams (for prescription glasses)

• Dentures

• Cosmetic surgery  

• Massage therapy

• Routine physical exams

• Hearing aids and exams for fitting them

• Concierge care (also called concierge medicine, retainer-based medicine, boutique medicine, platinum practice, or direct care)

• Covered items or services you get from an opt-out doctor or other provider (except in the case of an emergency or urgent need​

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I do not offer every plan available in your area. I currently offer plans with United Health Care, Aetna, Humana, Devoted, and Well Care. Any information I provide is limited to those plans that I do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE or your local State Health Insurance Program to get information on all of your options.​​​